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棰勯槻鏁堟灉涓嶄匠锛屾柊鍐犵柅鑻楃殑缂洪櫡鏇濆厜锛屾湭鏉ュ浣曞簲瀵癸
更新时间:2023-02-01

寮鸿揩鐥囧紡澶暱涓嶇湅鐗堬細

  • 1鐩墠鐨勬柊鍐犵柅鑻楅闃叉劅鏌撹兘鍔涘緢宸紱
  • 2鎵撶柅鑻楁垨鎰熸煋杩囧潎鍙兘鍐嶆鎰熸煋锛?/span>
  • 3鍙樺紓鏍細璁╃柅鑻楀彉寰楄秺鏉ヨ秺宸紱
  • 4鍙嶅鎺ョ鐤嫍鏃犳硶瑙e喅闂锛?/span>
  • 5鐗╃悊闃叉姢鎺柦浠嶇劧浼氭湁鏁堬紱
  • 6鐤嫍浠嶇劧鏈夊彲闈犵殑浣滅敤锛?/span>
  • 7鏂扮柅鑻楀拰鎶椾綋鍦ㄨ矾涓娿€?/span>

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棰勯槻銆屾劅鏌撱€嶆晥鏋滀笉浣?/strong>

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灏界杩欏彞璇濆畬鍏ㄥ惁瀹氫簡瀵规湁鐥囩姸鎰熸煋锛屽挨鍏舵槸瀵归闃蹭綇闄㈢梾渚嬨€侀噸鐥囩梾渚嬩互鍙婃浜$梾渚嬬殑鏈夋晥鎬э紝浣嗕笉鑳藉惁璁ょ悊鎯崇殑鐤嫍搴旇鏃㈣兘鎻愪緵銆?strong>瀵瑰彂鐥呯殑淇濇姢銆嶄篃搴旇鎻愪緵銆?strong>瀵规劅鏌撶殑淇濇姢銆嶃€?/p>

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鏃╂湡淇′娇鏍哥硸鏍搁吀锛坢RNA锛夌柅鑻楀銆屾劅鏌撱€嶇殑鏈夋晥鎬э紙淇濇姢鏁堝姏锛?strong>楂樿揪95%锛岃€屽叾浠栨捣澶栫柅鑻楃殑淇濇姢鏁堝姏鍒嗗埆鏄?6.5%锛圓d26鑵虹梾姣掞級銆?2.3锛圕hAd-Y25鑵虹梾姣掞級銆?0.6%锛堢伃娲?鍗板害锛塠1]锛涜€屽浗鍐呭浜庣伃娲荤柅鑻楃殑鏈夋晥鎬ф棭鏈熻鏂伴椈鎻忚堪涓恒€屾棤涓€鎰熸煋銆嶏紝鑰屽悗鐨勪笁鏈熶复搴婄爺绌朵篃鎵撶牬浜嗚繖涓€璇存硶[2,3]銆?/p>

鍥炬簮锛氬弬鑰冩枃鐚?

杩欎簺锛岄兘瀵艰嚧浜嗕汉浠鍚勭鏂板啝鐤嫍棰勯槻銆屾劅鏌撱€嶇殑鏈夋晥鎬х殑鏈熷緟銆?/p>

鐒惰€屼簨瀹炲憿锛熷寘鎷?5%鍦ㄥ唴鐨勭浉鍏虫暟鎹疄闄呬笂鏄柊鍐犵柅鑻楀鍖呮嫭銆?strong>鏈夌棁鐘舵劅鏌?/strong>銆嶆垨銆?strong>鏃犵棁鐘舵劅鏌?/strong>銆嶇殑鎬讳綋鏈夋晥鎬?/strong>锛圴Esym锛夛紝鑰屽浗鍐呯殑鐤嫍鍦ㄤ笁鏈熶复搴婄爺绌朵腑閲囩敤浜哣Esym浣滀负鏈夋晥鎬ф寚鏍囷紝浣嗗ぇ閮ㄥ垎鐮斿彂鍗曚綅閮藉彂甯冧簡杈惧埌浜嗕笘鐣屽崼鐢熺粍缁?0%鐨勮姹傜殑鐮旂┒缁撴灉锛堟棤璁哄悓婧愭帴绉嶈繕鏄紓婧愬姞寮猴級[4-8]銆?/p>

瀵逛簬銆?strong>鏃犵棁鐘舵劅鏌?/strong>銆嶏紝鏃╂湡浠呮湁鍩轰簬Ad26鍜孋hAd-Y25缁欏嚭浜嗛拡瀵规棤鐥囩姸鎰熸煋鐨勬湁鏁堟€э紙VEasym锛夛紝鍒嗗埆涓?4.6%锛?5% CI, -12.1 - 34.9锛夊拰65.5%锛?5% CI, 39.9 - 81.1锛塠9,10]锛岃€屽悗鍦ㄤ笉鍚屾瘨鏍祦琛屾湡闂寸殑闅忔満瀵圭収鐮旂┒鎴栭槦鍒楃爺绌惰瘉瀹炰笉鍚屾柊鍐犵柅鑻楀湪涓嶅悓鏃舵湡鎺ョ1鍓俶RNA鐤嫍鍚庡銆屾棤鐥囩姸鎰熸煋銆嶇殑VE鑼冨洿涓?6%-79%[11]锛岀敋鑷虫湁鐮旂┒鑰呰涓簃RNA鐤嫍瀵规棤鐥囩姸鎰熸煋楂樿揪90%鐨勬湁鏁堟€ц兘澶熸寔缁?strong>闀胯揪7涓湀涔嬩箙[12]銆?/p>

浠庢暟鎹潵鐪嬶紝鎸佷箙鎬ч潪甯哥悊鎯筹紝涓嶆槸鍚楋紵

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鐒惰€岋紝杩欎竴鍒囦粎鍋滅暀鍦?strong>濂ュ瘑鍏嬫垘锛圤micron锛屛匡級鍙樺紓鏍嚭鐜颁箣鍓嶃€?/p>

褰揙micron鏉ヨ鍚庯紝鍚勭鏂板啝鐤嫍鐨勫繀椤婚潰瀵圭殑鐜板疄灏辨槸锛氬鍖呮嫭銆屾湁鐥囩姸鎰熸煋銆嶅拰銆屾棤鐥囩姸鎰熸煋銆嶅湪鍐呯殑銆屼换浣曟劅鏌撱€嶉兘澶ф墦鎶樻墸鈥斺€斾笉浠呰闈㈠棰勯槻鎰熸煋鐭湡鏈夋晥鎬ч檷浣?/strong>鐨勬寫鎴橈紝鏇磋鎺ュ彈闅忕潃鏃堕棿鎺ㄧЩ瀵规劅鏌撴湁鏁堟€ц繕浼?strong>鎸佺画涓嬮檷鐨勭幇瀹炪€?/p>

涓嶅悓鏂板啝鐤嫍鍦∣micron鏃舵湡鐨勬湁鏁堟€13,14]

涓嶈繃锛屾劅璋㈡柊鍐犵梾姣掔粰鎴戜滑鐣欎簡涓€鏉℃椿璺細鏃犺鏄厤鐤帴绉嶈繕鏄厤鐤拰鎰熸煋鍧囨湁鐨勩€屾潅鍚堝厤鐤€嶏紙hybrid immunity锛夊潎鑳芥彁渚?strong>楂樻晥涓旂浉瀵?strong>琛板噺缂撴參鐨勫棰勯槻閲嶇棁鐨勬湁鏁堟€р€斺€斿敖绠?strong>绐佺牬鎰熸煋鍜?strong>鍐嶆劅鏌?/strong>椋庨櫓浠嶇劧瀛樺湪銆?/p>

鎴栬鍦ㄦ湭鏉ワ紝姣忎竴涓汉閮戒笉鍙伩鍏嶆劅鏌撯€斺€旂敋鑷?strong>鍐嶆劅鏌?/strong>鈥斺€旀柊鍐犵梾姣掞紝鑰岀柅鑻楃殑浣滅敤浠呰兘閫€鑰屾眰鍏舵锛屾妸閲嶅績鍜屽畾浣嶆斁鍦ㄦ彁渚涢珮鏁堝閲嶇棁鍜?strong>姝讳骸涓婁簡銆?/p>

2

涓嶅彲蹇借鐨勫啀鎰熸煋椋庨櫓

褰撶柅鑻楀凡缁忛毦浠ユ姷鎸°€屾劅鏌撱€嶏紝閭d箞灏变笉寰椾笉鎺ュ彈琚柊鍐犵梾姣掓劅鏌撶殑缁撴灉锛岃繖鏃舵垜浠兘浼氬惉鍒颁袱绉嶅緢寮虹儓鐨勫0闊筹細

1.闃宠繃涔嬪悗灏变笉浼氬啀闃充簡銆?/strong>

2.鎰熸煋杩囦竴娆℃柊鍐犵梾姣掑悗浠ュ悗鐥囩姸瓒婃潵瓒婅交銆?/strong>

浜嬪疄涓婏紝绗竴绉嶈娉曟棭鍦?020骞村氨宸茬粡琚惁瀹氫簡锛屽綋鏃舵渶鏃╁彂鐜版牳閰稿凡缁忋€岃浆闃淬€嶇殑鎮h€呮湁16.04%鍑虹幇浜嗐€屽闃炽€峓15]锛岃€屽悗鍦?021骞寸殑涓€椤瑰洖椤炬€х爺绌朵篃鍙戠幇锛屻€屽闃炽€嶅苟闈炰釜妗圼16]銆?/p>

褰撶劧锛屻€屽闃炽€嶅苟涓嶈兘璇佹槑鏄啀娆℃劅鏌撲簡鏂板啝鐥呮瘨[17]锛岃€屽湪鐩稿叧鐮旂┒鍙戝竷鍚庡浗鍐呭崼鐢熼儴闂ㄤ篃蹇€熼拡瀵规绫荤幇璞′簣浠ュ洖搴旓紝琛ㄧず澶嶉槼浜虹兢浼犳煋椋庨櫓寰堜綆锛屼絾浠嶅瓨鍦ㄤ紶鏌撴€с€?/p>

褰撴垜浠洜涓恒€屽闃炽€嶉闄╀笉楂樸€佷笖鏆傛椂娌″彂鐜颁細鎰熸煋涓ゆ鏂板啝鐥呮瘨鑰屾澗涓€鍙f皵鏃讹紝鍏ㄧ悆棣栦緥銆屽啀鎰熸煋銆嶇殑鐥呬緥鍙堝皢浜轰滑鐨勫績鎻愬埌浜嗗棑瀛愮溂鍎库€斺€旇繖鎰忓懗鐫€锛屾兂鍗曠函閫氳繃鎰熸煋濉戦€犲嚭銆?strong>缇や綋鍏嶇柅銆嶅睆闅滅殑鍙兘鎬ц秺鏉ヨ秺浣庛€?/p>

鑰岃捣鍒濓紝寰堝浜虹悊鎯崇殑璁や负锛岄€氳繃鏂板啝鐤嫍鍙互濉戦€犵敱銆屽厤鐤帴绉嶃€嶅閫犵殑缇や綋鍏嶇柅锛岀劧鑰屽嵈琚柊鍐犵梾姣掑嚮鐮翠簡锛涜€屽彟涓€浜涗汉璁や负锛屽氨鍍忔劅鏌撲竴娆″氨鑳界粓韬厤鐤殑姘寸棙鎴栭夯鐤逛竴鏍凤紝渚濋潬銆屾劅鏌撱€嶅閫犵殑缇や綋鍏嶇柅鏄潥涓嶅彲鎽х殑锛屼絾鍚屾牱琚幇瀹炲嚮鐮翠簡銆?/p>

2020骞?0鏈堝湪銆婃煶鍙跺垁銆嬫潅蹇楀彂甯冪殑涓€绡囨枃绔犳彁鍒帮紝涓€鍚嶇編鍥界敺瀛愬垎鍒湪4鏈堝拰5鏈堜袱娆℃劅鏌撲簡鏂板啝鐥呮瘨锛岃繖涔熸槸鍏ㄧ悆棣栦釜琚寮忚褰曠殑銆屽啀鎰熸煋銆嶇梾渚嬶紱涓嶄粎濡傛锛岃繖鍚嶇敺瀛愬嚭鐜般€屽啀鎰熸煋銆嶅悗锛?strong>鐥囩姸鐢氳嚦瑕佹瘮棣栨鎰熸煋鏇村姞涓ラ噸[18]銆?/p>

銆屽啀鎰熸煋銆嶇梾渚嬬殑鐤剧梾鐗瑰緛[19]

鍐嶄箣鍚庣殑鏁呬簨灏卞彉寰楅『鐞嗘垚绔犺捣鏉ワ紝銆屽啀鎰熸煋銆嶇梾渚嬩簬涓浗棣欐腐鐗瑰尯銆佹瘮鍒╂椂銆佸巹鐡滃灏旂瓑鍦伴檰缁鎶ラ亾[19]銆傝€屽悗鐨勫椤圭爺绌跺彂鐜帮紝涓嶄粎銆屽啀鎰熸煋銆嶅彲鑳藉彂鐢熷湪棣栨鎰熸煋鐨勪竴涓湀鍐咃紝涔熷彲鑳藉嚭鐜板湪鍗婂勾鍚庯紝鍙笉杩囩浉瀵规潵璇存瘮渚嬭緝浣嶽20-24]銆?/p>

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